Evaluation of Open Source Software Platform For Transperineal In-Bore MRI-Guided Targeted Prostate Biopsy

Abstract

Current targeted prostate biopsy methods often rely on commercial systems to support the procedure. These systems tend to lack the export of analysis results for secondary analysis studies used in research. Transperineal in-bore MRI-guided prostate biopsy (tpMRgBx) is one such targeted biopsy approach that lacks a commercial system to support the procedure. This work aims to investigate the use of open-source tools in creating an open-source platform that can support the tpMRgBx procedure while allowing access to the data necessary for analysis but also for comparison (to other targeted biopsy approaches). An open-source platform, SliceTracker, was presented with support for all steps of the tpMRgBx research workflow. Evaluation metrics were defined for a retrospective and prospective study of patients who underwent tpMRgBx. Retrospective evaluation studied registration accuracy, effect of the segmentation approach, and re-identification time of biopsy targets. Prospective evaluation focused on total procedure time as well as biopsy target re-identification accuracy. Results from the 73 retrospective and 10 prospective tpMRgBx cases showed success in the use of SliceTracker for supporting tpMRgBx. Mean Landmark Registration Error (LRE) for retrospective evaluation was 1.88 ± 2.63 mm and was not sensitive to the approach for prostate gland segmentation. For the prospective data, a target re-identification time of 4.60 ± 2.40 min and biopsy targeting error of 2.4 ± 0.98 mm was observed. The proposed platform SliceTracker was successfully integrated into the clinical research procedure at the institution in this study, supporting hundreds of cases to date. It is extensible and supports uniform collection of research data. This work represents a stride towards facilitating comparison between targeted prostate biopsy methods and the goal of improving prostate cancer care. It also provides a platform that is better suited to support translation of the tpMRgBx procedure to other sites.